| NPI | 1568462141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MS 13990) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35077616) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2014-02-20 |